Pharmaceutical treatment for the so-called idiopathic oligozoospermia (I. O.) is possible and effective in a fairproportion of patients with the syndrome provided that appropriate investigative procedures may identify...Pharmaceutical treatment for the so-called idiopathic oligozoospermia (I. O.) is possible and effective in a fairproportion of patients with the syndrome provided that appropriate investigative procedures may identify the major disor-der or its level of disruption, this abnormality is reversible and appropriate prognostic indices for the treatment's successare devised and validated. According to the evidence available, minimal evaluation and prognostic indices for treatmenteligibility in normogonadotropic men with I.O. include a routine work-up but, mainly, microscopical assessment ofspermatogenesis and appraisal of Sertoli cell's functional capacity. Published data indicate that men with hypospermato-genesis without maturational arrest, respond favorably to agents stimulating Sertoli cells and germinal epithelium withincreased sperm production. Furthermore, Sertoli cell activity as judged by cell-specific indices such as inhibin B secre-tion, may provide additional discriminating power to the microscopical picture of the testis. In this context, precise i-dentification of the causative factor(s), together with the establishment of prognostic indices are the most important cri-teria on which the decision, for or against medical treatment in I. O., should be based. Obviously, further basic re-search and clinical trials are urgently needed in this particular field, and this should be a major task for clinical androlo-gists. (Asian J Androl 2000; 2: 25 - 32)展开更多
文摘Pharmaceutical treatment for the so-called idiopathic oligozoospermia (I. O.) is possible and effective in a fairproportion of patients with the syndrome provided that appropriate investigative procedures may identify the major disor-der or its level of disruption, this abnormality is reversible and appropriate prognostic indices for the treatment's successare devised and validated. According to the evidence available, minimal evaluation and prognostic indices for treatmenteligibility in normogonadotropic men with I.O. include a routine work-up but, mainly, microscopical assessment ofspermatogenesis and appraisal of Sertoli cell's functional capacity. Published data indicate that men with hypospermato-genesis without maturational arrest, respond favorably to agents stimulating Sertoli cells and germinal epithelium withincreased sperm production. Furthermore, Sertoli cell activity as judged by cell-specific indices such as inhibin B secre-tion, may provide additional discriminating power to the microscopical picture of the testis. In this context, precise i-dentification of the causative factor(s), together with the establishment of prognostic indices are the most important cri-teria on which the decision, for or against medical treatment in I. O., should be based. Obviously, further basic re-search and clinical trials are urgently needed in this particular field, and this should be a major task for clinical androlo-gists. (Asian J Androl 2000; 2: 25 - 32)